[[1]] "Scariest Hospital Risks"
While not addressed directly in the article, it underscores the need for a sound, efficient and safe waste management system, which is critical in preventing the spread of bacteria/disease. Before our brainstorm I had never thought about waste and the implications of its use/misuse (I guess out of sight out of mind!) but now I see it as an essential component.

[[2]] "A Treatment Room with a View"
Interesting article on evidence-based design and the call for more patient-friendly hospitals. As one expert states, ""Most veterinarians put their patients in better surroundings than patients who are getting chemo." Yikes. What did hospitals do before they employed evidence-based design? Is the rise of E-BD parallel to the increase in patient and family centered care?

MUSINGS of interest along the way:

(9/20) During our field observations at the ED today I was struck by the ability of the nurses to adapt to seemingly oppressive environmental conditions. Humans are very adaptable creatures in general--its amazing what we can "get used to". Walking through the halls I was overcome by a sense of claustrophobia and over-stimulation which I feel is due, in large part, to the lighting, which is intense and incessant. No windows (natural sunlight), no ability to modulate lights, no variations throughout the day. Many times these nurses come in at dark and leave at dark never seeing the light of day, disrupting their body's orientation and rhythms. When asked how they felt about the lighting conditions, they generally said "it's fine." The same holds true for the lack of interior design/decoration. No color, no sense of comfort and humanity in the physical landscape. Seems like such a simple, obvious and easy way to at least temporarily ease stress and distress. The whole time I kept thinking, why are hospitals so inhospitable?

(9/23) I've been reading an interesting book called Light, Air and Openness: Modern Architecture Between the Wars [3] which examines the 1920s/30s preoccupation with clean, hygienic, white spaces with lots of light and fresh air as part of a healing environment. These modernist design principles were used in hospitals and sanitoriums during this period (and to my surprise are not sterile looking at all.) I can't help but think of the dreariness of the ER, and its lack of both sun and fresh air, and how essential these ingredients are for physical and emotional well-being.

(9/25) Been thinking about the effectiveness of field observation techniques--interviews versus observations--as well as the effectiveness of questioning. Last week my group and I went to the Emory C-L ED--it was a very slow afternoon so we didn't have a chance to see problems "in action." Instead we relied heavily on informal interviews with staff. While this is an invaluable part of data collection, it is incomplete. Value is attained when we can corroborate the interview with identifiable actions. So I wonder what we were missing! Also interesting to see how the strength and precision of the questions can influence the answer. When asked a general question about the lighting, for example, the nurse reaction was "it's fine." When probed further, problems began to emerge.